Ui_RPA-in-Healthcare.pdf

P . 1
U I P A T H . C O M
Robotic Process
Automation (RPA) in the
Healthcare Sector
HEALTHCARE
Removing the Barriers for Better Patient Care

P . 2
U I P A T H . C O M
Contents
RPA: The Data-Wiring For A Robust And Accessible
Healthcare System ��3
Use Case: RPA Can Make The Insurance Approval
Process Faster And More User Friendly ��4
Taking On Goliath One Step At A Time ��5
Digital Technologies Empower Providers
To Better Care For Patients ��6
Taking A Step In The Right Direction For Healthcare Payers ��8
RPA Is Always Evolving, Enabled By AI ��10
Don’t Believe The Hype On Generalized AI ��11
Automation First: Now’s The Time To
Explore Automation’s Potential ��11
Use Case: Automate The Provider-Credentialing Process ��11
Public Sector Healthcare: A Lesson From The United States��12
Getting Started With Automation In Healthcare��15
Explore Your Processes And Start Automating ��16
Works Cited��17
UIPATH IS LEADING THE “AUTOMATION FIRST” ERA – championing one robot
for every person, delivering free and open training, and enabling robots to
learn new skills through artificial intelligence (AI) and machine learning. Led
by a commitment to bring digital-era skills to more than a million people,
the company’s enterprise Robotic Process Automation (RPA) platform has
already automated millions of repetitive, mind-numbing tasks for business
and government organizations all over the world, improving productivity,
the customer experience and employee job satisfaction.

P . 3
U I P A T H . C O M
Governments and healthcare stakeholders
further attempt to create a resilient and
more prosperous society through creating a
robust and accessible healthcare system.
Healthcare professionals want to bring high-
quality healthcare to the broadest population
possible. To do so, however, providers and
payers alike have to complete and manage a
myriad of forms, paperwork, and information.
All this information—patient records; provider
information; billing and payment data
—is
collected, processed, filed, and stored in a vast
array of siloed and disparate systems.
Operating in this space becomes even more
complicated when one considers the entire
infrastructure that supports the healthcare
system: HR departments, IT departments, and
supply chains.
RPA: The data-wiring for
a robust and accessible
healthcare system
Whether working for a healthcare provider or payer, most
healthcare professionals work toward a similar goal: to
extend high-quality, affordable healthcare to the broadest
population possible.
The multitude of processes and web of networks
have made healthcare convoluted and sluggish,
resulting in care that can be more expensive,
slower, and less effective for the patient. For
private providers, this also means lower profits.
The price and negative consequences of that care
fall predominately in the laps of taxpayers and
individual patients or their familial networks.
Further, the healthcare industry is facing a
need to digitally transform their organizations.
Some of the compulsion to digitalize derives
from government mandates and others from
increasing demand to stay competitive. There
is a way that stakeholders in the healthcare
industry can make the system more efficient.
Robotic Process Automation (RPA) is a tool that
supports digital transformation. Conceptually,

P . 4
U I P A T H . C O M
RPA can make the insurance approval process
faster and more user friendly.
In the U.S., when a patient goes to a physician
for care, the patient must first register with the
place of care. During the registration process,
hospitals and health systems are required to
measure a patient’s predicted length of stay, the
risk a patient poses, and other factors that can
affect patient satisfaction and reimbursement.
Obtaining insurance approvals as soon as
possible is vital in order to calculate the length
of stay and forecasted reimbursement.
RPA can make the insurance approval process faster
and more user friendly
RPA presents
a very real
opportunity for
the healthcare
system to stop
the bleed of rising
costs across
the globe. RPA
and Intelligent
Automation can
lead the way in
eliminating waste
and changing the
consumer’s health
journey”
–
Nikki Ahlgren,
Customer Success
Director and Healthcare
expert, UiPath.
Advice and thoughts
from UiPath healthcare-
focused Customer
Success Managers
However, U.S. hospitals on average can have
around 29 different disparate electronic
systems that house a patient’s information.1
These systems are rarely integrated, and the
lack of integration slows down the insurance
approval process, and ultimately revenue cycle
management.
RPA robots can be programmed to gather all
the relevant data, even if housed in disparate
locations, and to push it to the appropriate
employee handling registration much faster than
if an employee performed the process manually2
.
it is the wiring that can link all the data in all the
systems together in a faster, more accurate, and
more efficient way than heavy business process
management systems, custom application program
interfaces (APIs), and other traditional IT approaches.
RPA enhanced with artificial intelligence (AI) can
push and pull a vast array of data from system
to system quickly and accurately. In addition to
accelerating the system, it takes the time-consuming,
low-value tasks out of human hands, freeing them
up to do more value-added work.
1
Weber, Lisa, “RPA and AI: Physician Practice and Hospital
Use Cases,” 2018.
2
Ibid
USE
CASE
“

P . 5
U I P A T H . C O M
Taking on Goliath
one step at a time
Figuring out how to achieve desired healthcare outcomes
is a massive challenge, due to the sheer numbers of people
targeted (as many as possible) and the funding needed
to reach the target group. The healthcare industry is an
$18 trillion global economy,4
employing approximately
13 million people in the United States alone.5
Healthcare
spending is gigantic, and has increased steadily since the
year 2000.6
The healthcare sector is also experiencing one of the
most disruptive periods to date. While providers confront
hindering factors to improve patient outcomes, increase
operating margins, and improve patient experiences, many
payers operate on disjointed and fragmented systems
and are facing declining profitability.7
These demands are
causing consolidation in the industry, resulting in the need
for the large-scale data integration, process automation,
and advanced analytics.8
It’s easy to lose sight of the patient
within this colossal network.
3
https://tincture.io/prelude-to-himss19-technology-isnt-healthcare-
959b02e8df0b
4
https://www.kff.org/other/state-indicator/total-health-care-employ
ment/?currentTimeframe=0sortModel=%7B%22colId%22:%22Locat
ion%22,%22sort%22:%22asc%22%7D
5
https://apps.who.int/iris/bitstream/handle/10665/276728/WHO-
HIS-HGF-HF-WorkingPaper-18.3-eng.pdf?ua=1
6
Where applicable: not all payers are for-profit, as is the case with
German Krankenkassen
7
Weber, Lisa, “RPA and AI: Physician Practice and Hospital Use
Cases,” 2018.

P . 6
U I P A T H . C O M
A healthcare provider can be a person (such
as a doctor, a nurse practitioner, a clinical
psychologist) or the institution of care (hospitals,
nursing homes, or hospice agencies).8 9
Evolving
technologies, a growing patient advocacy culture,
changing expectations in the patient-provider
relationship, and demographic and economic
shifts are propelling new demands for providing
care.10
Further, healthcare providers face constant
pressure to improve patient outcomes and
experiences, while simultaneously reducing costs.
When harnessed correctly, digitization and new
technologies can reinforce patient care, increase
a provider’s revenue, speed up cash flow, and
increase patient and employee satisfaction.
Hospital and clinic administrative staff,
physicians, and nurse practitioners all carry out to
some degree repetitive rules-based activities that
can be automated to give them more time for
higher-value work.
The activities carried out in the healthcare
provider space can be understood as activities set
up along the patient’s journey for consultation,
treatment, and payment for the care. One way
to view the activities in this journey is by dividing
them up into three time periods: pre-visit, visit,
Digital technologies empower providers to better
care for patients
and post-visit activities. Pre-visit activities are all
the tasks that set the patient up for the visit with
their provider. Visit activities are the activities
performed while the patient is at the provider,
and post-visit activities are those that revolve
around ensuring payment for the provided care.13
8
https://hr.berkeley.edu/node/3777
9
Examples of healthcare providers found at the healthcare.gov
website https://www.healthcare.gov/find-provider-information/
10
https://www2.deloitte.com/content/dam/Deloitte/global/
Documents/Life-Sciences-Health-Care/us-lshc-hospital-of-the-
future.pdf
11
Interviews with UiPath Healthcare Expert, Lisa Weber

P . 7
U I P A T H . C O M
Many of these tasks are still carried out
manually by administrative staff, doctors, nurses,
and other practitioners. Errors that occur during
manual entry can slow down the provider getting
paid for their services, and when operating on
razor thin margins, that speed matters.
Take for instance one of the visit activities:
completing and signing forms. When a patient
checks-in at a physician’s office, the patient is
typically given forms to complete: demographic
background, medical history, required regulatory
forms like HIPAA or GDPR, and more. The
responsible staff uploads the information either
by scanning it in or entering it manually. The work,
Healthcare provider activities divided into three time periods
while necessary for treating a patient effectively,
is tedious and rife with duplication errors.
However, software robots can enhance the
data entry process. An RPA robot can enter
pertinent and specific health information into
a patient’s Electronic Medical Record (EMR).
Because RPA robots have greater accuracy than
humans, the EMR will be more robust, and staff
can use their extra time more efficiently.
Providers can use RPA robots for all the activities
listed in the chart above. Picking the task with
the most potential for an automation pilot
program is one of the real initial challenges.
Don’t try to automate
your hardest and most
complicated process first.
Look for the low-hanging
fruit that has the most
repetitive, manual steps
that cause heartburn for
the end user. End-user
buy-in will be critical for
success and quick wins
will generate buy-in for
future backlog ideation.
Executive sponsorship of
the automation program
will be required when
looking to scale.”
–
Nikki Ahlgren,
Customer Success Director and
Healthcare expert, UiPath.
Advice and thoughts from
UiPath healthcare-focused
Customer Success Managers
“
•
Scheduling the visit
• Registering
demographics
• Insurance
verification and
validation
• Checking in
•
Completing and signing
forms (HP, HIPAA, financial
policy),
• Seeing the provider
•
Receiving a treatment plan
•
Ordering additional Tests
or Labs, etc.
•
Submitting the
insurance claim
• Billing the patient
•
Posting payments
and adjustments
•
Managing and
following up on
the account
VISIT POST-VISIT
PRE-VISIT

P . 8
U I P A T H . C O M
Taking a step in the right direction
for healthcare payers
The way a nation’s healthcare system is
designed results in a variety of challenges for
its payers. In a single-payer healthcare system
like that of the United Kingdom (U.K.), Spain,
or New Zealand, government-collected taxes
create a pool that pays for citizens’ healthcare
expenses.12
These systems can face the challenge
of meeting the nation’s healthcare needs,
extending service, and improving quality while
the funding source doesn’t increase, as is the case
with the U.K.13
When the public funding for the
healthcare system does not grow as fast as the
population and its increasing demands for care,
paying for healthcare becomes challenging.
For Japan, a country that guarantees the right
to universal healthcare and combines private
insurance with public insurance, while tightly
regulating the costs of healthcare procedures, it
faces another challenge. High life expectancies,
economic stagnation, and generally high prices
in technology have led to a strain on financing
the system.
The United States (U.S.) on the other hand has a
complicated system. 294 million Americans are
insured – roughly 91.2% of the U.S. population,
according to data published by the U.S. Census
Bureau.14
Additionally, 56% of Americans receive
health insurance from their employer, followed
by Medicaid (19.3% of Americans, and Medicare
(17.2%).15
The latter two systems are funded
by the government. In the for-profit insurance
sector, payers tend to be facing declining
profitability, driven by losses in their exchange
businesses, regulatory reforms, and market
competition.
Regardless of the system, to stay ahead of these
challenges the modern payer – private insurance
companies, government payers, or otherwise
– will need to identify manual and rules-based
activities to take advantage of emerging
technologies and automate. Process automation
is one major driver in an organization’s
digital transformation program that can drive
breakthrough performance.16
Similar to the provider example, one can
divide the activities of the healthcare payer
into particular segments based on the way it
interacts with the patient/customer. Many of
12
https://www.pbs.org/wgbh/pages/frontline/
sickaroundtheworld/countries/models.html
13
https://improvement.nhs.uk/about-us/who-we-are/
14
https://www.census.gov/content/dam/Census/library/
publications/2018/demo/p60-264.pdf
15
https://www.census.gov/library/publications/2018/
demo/p60-264.html
16
https://www.ey.com/Publication/vwLUAssets/ey-
digital-transformation-in-insurance/$FILE/ey-digital-
transformation-in-insurance.pdf

P . 9
U I P A T H . C O M
17
https://www.uipath.com/solutions/process/
healthcare-payer-automation
If an agency has gone through business process
management (BPM) or business process analysis
(BPA), that’s an ideal point in time to start RPA.
That’s because they’ve already looked at the tasks
and the workflows. So, the next logical step is RPA.
The agencies who have the most momentum are
those that have done BPM and BPA recently.”
–
Lydia Cooley, Sales Executive, US Federal Health Care, UiPath.
Advice and
thoughts
from UiPath
healthcare-
focused
Customer
Success
Managers
“
Payer activities segmented into interactions with patient/customer
these activities can be enhanced, sped up,
or pushed to gold-standards of accuracy
through with the help of RPA. Some of these
activities are visible in the chart at right.
In the payer world, one could look to the
example of claims management to see how
automation can enhance business goals.
Claims processes in general are usually
complex, manual intensive, cumbersome,
and error-prone.
For example, one healthcare insurer was
confronting a systematic and daily error
with their claims process. A range of one
thousand to two thousand claims were
bottlenecked due to an issue with an error
code. Employees in the claims group had
to manually change the error in order to
move these claims along in the process.
The manual work contributed to excessive
amounts of time and money spent. The
claims group was able to program an RPA
robot to take the same rules-based steps
human employees would take, which
significantly saved employees time and freed
them to focus on more valuable work.17
The activities mentioned in the list above,
which are just a few out of many, are areas
where healthcare payers could immediately
examine their own automation potential.
Managing
Plan Members
Billing
Members
Managing
Network
Providers
Managing
Payment
Claims
Customer
Service
Eligibility
check
Enrollment
applications
Account
reconciliation
Payment
processing
Subsidy
processing
Provider
credentialing
Provider data
management
Performance
management
Claims intake
Claims
processing and
adjustment
Fraud
management
Service
requests
Customer
assistance
RPA can enhance, sped up, or push these
activities to gold-standards of accuracy.

U I P A T H . C O M P . 1 0
RPA is always evolving, enabled by AI
RPA is a technology that helps automate routine, rules-based, and repetitive
tasks to create a digital workforce that can focus on more value-added work.
Required capabilities for AI-enhanced RPA
The technology allows businesses and
organizations to configure computer
software which emulates the way
humans interact within digital systems
to execute a business process.
RPA is continuously evolving,
developing new capabilities, and
making process automation more
efficient. The introduction of AI to
RPA has enabled it to evolve from
automating rules-based and repetitive
tasks to increasingly complex and
cognitive tasks.
AI can be generally described in one
of two broad types: pragmatic AI or
general AI. Pragmatic AI is AI which
solves specific customer needs and
delivers immediate ROI, whereas
General AI (also at times called pure AI)
is theoretical. RPA robots are learning
new skills enabled by Pragmatic AI.
This type of AI can be expressed in
terms of pillars and capabilities.
Visual
Understanding
Document
Understanding
Process
Understanding
Conversational
Understanding
Automatically
identifies and
completes UI
elements
Reduces the need
for technical
selectors
Maintains
automation
robustness even
after software
upgrades
Understands and
analyzes structured
and unstructured
document data
with template-
less processing
of receipts and
expenses
Aids in invoice
extraction and
processing
Observes user
behavior to discover
and learn common
tasks and processes
automatically
Prioritizes automation
opportunities based
on expected ROI of
identified processes
Auto-generates
robot configurations
based on as-is design
or with efficiency
improvements
Analyzes
sentiment of text,
chat, and voice
inputs
Classifies natural
language inputs
in order to
automatically
route them to the
right team,
Executes requests
and actions from
chatbots and
voice assistants

U I P A T H . C O M P . 1 1
Don’t believe the hype on
generalized AI
Automation First: now’s the time to explore
automation’s potential
In popular culture and news reports, AI is often
described as a complex, multi-functional, self-
learning super algorithm with a mind of its own.
Don’t believe it. While impressive advancements
have been made in AI over the past several
years, this type of complex, generalized AI is not
realistic. The reality is that generalized AI is nearly
impossible to develop, even harder to deploy,
and has not demonstrated any ability to deliver
meaningful ROI in solving real customer problems.
AI-enhanced RPA comes at a time where
automation and AI-enhanced automation are
becoming a ubiquitous part of our everyday
lives. Dr. Amy Webb, a quantitative futurist,
spoke at the World Economic Forum’s Davos
conference in January 2019 about the immediacy
of AI. “AI is more than a buzzword and it’s not a
tech trend. It’s the third era of computing, which
is to say every single facet of our lives and our
work ties into that third era of computing.” 18
USE
CASE
When a payer wants to add a new provider
to its network, the provider’s information
must be systematically validated in a process
known as provider credentialing.19
It is a
time-consuming, yet unavoidable process
that involves multiple steps, including filling
out an enrollment form, entering data from
the form into the payer system, validating the
information received, and more.
RPA is an excellent assistant in this entire
process. A software robot can scan the
forms filled out and received by the provider
and enter that data into the payers’ systems.
Further, it can be programmed to interact
with websites used for validation. Whether
the payer is trying to validate educational
qualification or services offered by the
provider, when these tasks are routine-based,
RPA can take them off the hands of employees,
carry them out at any time of the day, and
inform the responsible employee when
exceptions have been found or when human
intervention is needed.
Automate the provider-credentialing process
Given the current pervasiveness of these
technologies, and the undisputable trend towards
increased automation, AI-enhanced RPA offers
greater efficiency for business outcomes. The
mindset of exploring the automation potential of
a business is a winning approach.
18
https://www.reuters.tv/l/PeoC
19
Provider credentialing is also a step that employers
do when hiring physicians. Hospitals, clinics and
other healthcare institutions can also use RPA to
verify provider credentials.
The benefits gained from automating the
provider-credentialing process include a
reduction in operating costs, increased
process accuracy, improved compliance,
and faster onboarding of a provider into
the payer network.

U I P A T H . C O M P . 1 2
Public sector healthcare: a lesson from the
United States
In T.R. Reid’s book, “The Healing
of America: A Global Quest for
Better, Cheaper, and Fairer
Health Care,” the author and
former Washington Post
correspondent, categorizes the
world’s some 200 countries’
healthcare systems into four
broad healthcare models
established to accomplish
three main goals. While this
is just one classification of
healthcare models, it helps in
conceptualizing trends in public
sector healthcare. A chart of the
models can be found at right.
According to Reid, the United
States combines aspects of all
model types. While Medicare
and Medicaid resemble the
NHI model, the Veteran’s
Administration has been
historically more similar to the
Beveridge model, and employee-
insured Americans tend toward
the Bismarck model. Thus, it’s
impossible to have a discussion
The Beveridge Model Out-of-Pocket Model
The Bismarck Model
The National Health
Insurance Model (NHI)
Outcome:
Properties
Government provides health
care financed by taxes
Many hospitals clinics are
owned by the government
Doctors can be both private
doctors and government
employees.
Private doctors collect fees
from the government
Properties
Those who can afford
healthcare, through
bartering, trade, or some
form of currency can be
seen and treated by
a healthcare provider
Providers can range
from trained physicians
to local healers
Properties
Insurers tend to be
financed by employers and
employees through payroll
deduction.
Not-for-profit health
insurance plans cover
entire citizenry
Predominately private
healthcare providers
Properties
Government pays private
sector providers.
Insurance is universal.
Government has greater
power to negotiate
medical prices
Keeps people healthy | Treats the sick | Protects families against financial ruin from medical bills
Great Britain, Spain,
New Zealand*
The majority of
our planet*
Germany, France, Belgium
The Netherlands, Japan*
Canada, Taiwan,
South Korea*
*Chart is not an exhaustive list of nations and how they fit into the four models, but an example of some nations’ healthcare systems.

P . 1 3
U I P A T H . C O M
on creating desired results in the U.S. healthcare
system without discussing the role of the public
sector. Moreover, there are lessons to draw
out from this discussion for other public sector
providers as well.
According to data released in 2018 by the Center
for Medicare Medicaid Services (CMS), the
U.S. government spends most of the budget on
healthcare (Medicare, Medicaid, the Children’s
Health Insurance Program (CHIP), and Affordable
Care Act (ACA) marketplace subsidies). In 2017
the U.S. government spent roughly $1 trillion
on health insurance programs, equating
approximately one quarter of the overall
budget.22
Growing federal spending on health
programs is a trend that dates back decades, and
is one that is predicted to continue. 23
For policymakers and stakeholders, stunting
those healthcare costs for the government (and
the individuals) is crucial. Initiatives such as
value-based payment initiatives, which strive to
encourage payment for positive health outcomes,
21
https://www.pbs.org/video/frontline-sick-around-
the-world/
22
https://www.cbpp.org/research/federal-budget/
policy-basics-where-do-our-federal-tax-dollars-go
23
https://www.crfb.org/papers/american-health-care-
health-spending-and-federal-budget
24
https://www.rand.org/pubs/testimonies/CT381.html
25
https://www.whitehouse.gov/wp-content/
uploads/2018/08/M-18-23.pdf
“Agencies should develop and implement reforms to eliminate
unnecessary or obsolete compliance requirements and reduce
the cost of mission-support operations. Reforms may include …
introducing new technologies, such as RPA to reduce repetitive
administrative tasks …” – OMB Memorandum M-18-23.
is one way in which the U.S. government has
attempted to reign in the healthcare spending.24
Another way is through shifting the way
government agencies perform their tasks.
There are several tasks performed each day
within government agencies that are repetitive
and rules-based tasks that can be successfully
automated. In fact, in August 2018, the Office
of Management and Budget released a
memorandum directing executive agencies to
develop and implement strategies to, amongst
other initiatives, use technologies such as RPA
to reduce such tasks.25
With RPA, both payers and providers can help
reduce the time it takes for patients to see a
physician, decrease expenses, and improve the
quality of care for patients. The implications are
broad. Lydia Cooley, a UiPath Customer Success
Manager, who focuses on the healthcare sector
within the federal government, explained that
healthcare divisions within the federal government
can use RPA to achieve these objectives.
Automating processes in the
medical informatics field
Relieving interoperability issues
related to incompatible legacy
and mainframe systems
Eliminating repetitive work for
highly-paid knowledge workers
Facilitating timely payments
to federal contractors
Expediting the transfer of
patient records
RPA can improve processes,
improve the quality of care,
and decrease expenses by:

P . 1 4
U I P A T H . C O M
Describing how RPA has a huge impact in
back-office functions (financial management,
accounting, human resources) but also for the
mission-side of the sector, Ms. Cooley described,
“While on one hand, it’s about reducing costs
and serving the community of patients, it’s also
about the employees and removing the mundane
repetitive work so that these employees can
focus on higher-value work.”
Being able to identify and automate low-value
work is a lesson for all government payers,
especially when considering doing more valuable
work with the same amount of funding or less.
The municipality head from Trelleborg Sweden,
Fredrik Greijer found an increasing municipal
population putting strain on the administration’s
capability to work. The municipality opted to
automate repetitive tasks and do more higher-
value work with the funds they had. “If we fail to
do this, we will have to resort to tax increases,”
said Geijer in one interview.26
Automating also has cost savings and quality
and compliance benefits. The U.K.’s National
Health Services (NHS) Improvement found
that RPA could drive efficiencies in corporate
services by undertaking manual data entry, high-
volume work. Additionally, RPA could be quickly
implemented with a return on investment in less
than 12 months, and it could reduce business and
compliance risk by eliminating human error.27
Regardless of the type of system(s) a government
establishes to pay for healthcare, where there is
manual and repetitive rules-based work being
done, there’s room for automation. Moreover,
due to the need of government agencies to
achieve more without increasing spending,
automation poses a particularly viable solution.
Government providers should examine the
potential for automating the low-valued tasks
their employees are doing, to give them more
time on higher-value work.
26
https://www.uipath.com/solutions/industry/public-
sector-automation See video: “Automating administrative
tasks in the Trelleborg Municipality (1/2).”
27
https://improvement.nhs.uk/resources/robotic-process-
automation/

P . 1 5
U I P A T H . C O M
Getting started with
automation in healthcare
RPA has applications specific to the healthcare
industry and applications that one can find in any
large business. Considering the entire industry
McKinsey Company has predicted that up
to 36% of healthcare has the potential to be
automated with attended robots,29
UiPath
estimates that by including unattended robots,
up to 60% of the value chain can benefit from
RPA. In contrast, 36% of the processes are quickly
automatable with attended robots with a five-to-
six week implementation time.
Some of the back-office business functions are
the most tried and tested RPA deployments
that have fast implementation times and a
quick ROI. These functions include automating
the onboarding of new staff, invoice processes,
general reporting processes, claims management,
and supply chain processes, all of which are
applicable to healthcare. The automation of these
processes has an average implementation time of
5.2 weeks and an average ROI of 5.3 months.30
For providers and payers alike, the potential to
automate means thinking through the processes
they do daily that are repetitive and systematic. A
software robot can be programmed to take on a
variety of these tasks, accelerating cycle times and
freeing them up to provide the best possible care
for their customers. The tables below should
provide a few ideas of automatable processes
for providers and payers. Some of the tasks
may also overlap. For example, both providers
and payers verify the credentials of individual
healthcare providers.
PROVIDERS can automate a wide range of processes
Document processing
Healthcare providers can
automate intake, filing, and
processing of patient health
records, patient registration,
and other critical documents.
Prior authorization
Physicians can use RPA to collect
the vast array of information
needed and monitor the progress
of prior-authorization on a daily
basis, expediting the process and
cutting costs of manual work.
Propensity to pay
Providers can accelerate their
cash flow through programming
RPA robots to retrieve real-time
information on customer copay
and deductibles.
Regression testing
RPA robots can be used to aid
testers in the regression testing
process, through running tests,
pulling data and performing other
systematic testing steps. RPA robots
can perform parts of this process
significantly faster than humans.
29
https://www.mckinsey.com/business-functions/digital-
mckinsey/our-insights/where-machines-could-replace-
humans-and-where-they-cant-yet
30
Average implementation time and ROI has been
calculated from some 30 RPA deployments of UiPath RPA
solutions, for which data had been provided by the client
or its RPA implementation partner.

P . 1 6
U I P A T H . C O M
Explore your processes and start automating
RPA acts as a wiring mechanism that can retrieve
data, complete forms, perform systematic tasks,
and harness AI to understand unstructured data,
learn processes, and enhance the achievement
of humans working in the healthcare sector.
The primary impact of deploying RPA in this
sector is that it reduces and often eliminates
repetitive, mundane, manual tasks (which
reduce cycle times) for staff, and it improves
the interoperability between disparate systems
to close gaps in care and boost revenue cycle
management.
In its foundation, RPA tackles the manual,
time-consuming, and low-value tasks that both
providers and payers take on every day. As an
effective solution for tackling these mundane
tasks, RPA benefits everyone.
Providers can generate revenue by spending
less time on administrative tasks and
processes and repurposing that time to spend on
the patient. They can harness today’s technology
to offer optimal and thorough care for patients
who need it. Payers, likewise, can help their
members pay providers more quickly and more
efficiently. The combination of cost reduction
from both sides can help tackle rising healthcare
costs, which are a burden on all parts, but
predominately for tax payers and the patients.
Discover how to automate with UiPath
Contact our sales team!
Healthcare organizations – whether private
sector or public sector – should explore
immediately the various tasks and process
that they can automate using RPA. With
an estimated overall 60% of tasks that can be
automated, providers and payers both should
start automating those processes, as it’s in
the interest of their organizations, the human
employees, and the customers that lie at the
center of the health care industry.
PAYERS can automate tasks
The claims
management
process
An estimated 85-95%
of the manual and
time-consuming claims
management tasks can be
expedited and performed
more accurately with an
RPA robot.
The member
enrollment process
RPA can expedite the
enrollment of new
members into a payer’s
plan, by extracting data,
validating information, and
coordinating with human
employees.
Provider
credentialing
Payers can accelerate the
credentialing process by
automating RPA robots
to capture data, perform
validation tasks, and
provide the employees
with exceptions and
finalized documents.
Customer service
(CS) activities
RPA can reduce customer
service costs, provide a
better user experience,
and utilize the human
workforce for more
important tasks by
automating CS activities.
Centralized billing
office (CBOs)
CBOs can use enhanced
RPA to improve the quality
of patient phone calls and
to crunch data to more
speedily and accurately
produce necessary reports.

P . 1 7
Davenport, T. H. Ronanki, R. (2018). Artificial Intelligence for the Real World.
Harvard Business Review (January-February 2018 Issue). Available online at: https://
hbr.org/2018/01/artificial-intelligence-for-the-real-world.
Berchick, E.R., Hood, E., Barnett, J.C., (2018). “Health Insurance Coverage in the
United States: 2017.” Available online at: https://www.census.gov/content/dam/
Census/library/publications/2018/demo/p60-264.pdf
Berkley Human Resources, FAQ Page. Last accessed February 2019. Available online
at: https://hr.berkeley.edu/node/3777
Center on Budget and Policy Priorities (2019). “Policy Basics: Where Do Our Federal
Tax Dollars Go?” Available online at: https://www.cbpp.org/research/federal-
budget/policy-basics-where-do-our-federal-tax-dollars-go
Chui, Michael, Manyika, J., Miremadi, M., (2016). “Where machines could replace
humans—and where they can’t (yet).” Available online at: https://www.mckinsey.
com/business-functions/digital-mckinsey/our-insights/where-machines-could-
replace-humans-and-where-they-cant-yet
Committee for a Responsible Federal Budget (2018). “American Health Care: Health
Spending and the Federal Budget.” Available online at: https://www.crfb.org/
papers/american-health-care-health-spending-and-federal-budget
Damberg, Cheryl L. (2013). “Efforts to Reform Physician Payment: Tying Payment to
Performance.” Available online at: https://www.rand.org/pubs/testimonies/CT381.
html
Deloitte Center for Health Solutions (2017). “The hospital of the future: How digital
technologies can change hospitals globally.” Available online at: https://www2.
deloitte.com/content/dam/Deloitte/global/Documents/Life-Sciences-Health-Care/
us-lshc-hospital-of-the-future.pdf
Ernst Young (2017). “Digital transformation in Insurance.” Available online at:
https://www.ey.com/Publication/vwLUAssets/ey-digital-transformation-in-
insurance/$FILE/ey-digital-transformation-in-insurance.pdf
Executive Office of the President, Office of Management and Budget (2018).
Memorandum for Heads of Executive Departments and Agencies. Shifting from low-
value to high-value work. M-18.23. Available online at: https://www.whitehouse.gov/
wp-content/uploads/2018/08/M-18-23.pdf
Kaiser Family Foundation (KFF) (2017). Total Healthcare Employment. Available
online at: https://www.kff.org/other/state-indicator/total-health-care-employmen
t/?currentTimeframe=0sortModel=%7B%22colId%22:%22Location%22,%22sort%
22:%22asc%22%7D
Mittal, Vartul (2018). “How RPA is re-inventing the Insurance Industry!” Available
online at: https://medium.com/@vratulmittal/rpa-re-inventing-the-insurance-
industry-f3eb5d6ac05d
NHS Improvement Website, “Robotic Process Automation.” Available online at:
https://improvement.nhs.uk/resources/robotic-process-automation/
Reid, T.R. (2009), “The Healing of America: A Global Quest for Better, Cheaper,
and Fairer Health Care.” Excerpt on Health Care Systems - The Four Basic
Models available online at: https://www.pbs.org/wgbh/pages/frontline/
sickaroundtheworld/countries/models.html
Reid, T.R. (2008), “Sick around the World,” Frontline Season 26 Episode 11, 15 April
2008. Available online at: https://www.pbs.org/video/frontline-sick-around-the-
world/
Singer, John (2019). “Prelude to #HIMSS19 — Technology Isn’t Healthcare.” Available
online at: https://tincture.io/prelude-to-himss19-technology-isnt-healthcare-
959b02e8df0b
UiPath, “Automating administrative tasks in the Trelleborg Municipality (1/2).” UiPath
Website. Video available at: https://www.uipath.com/solutions/industry/public-
sector-automation
UiPath, “Healthcare payer meets RPA: The automatic claim repair solution for
happier healthcare customers.” UiPath Website. Available online at: https://www.
uipath.com/solutions/process/healthcare-payer-automation
United States Census Bureau, (2018). “Health Insurance Coverage in the
United States: 2017.” Available online at: https://www.census.gov/library/
publications/2018/demo/p60-264.html
Webb, Amy (2019). Panel Discussion “The Future Workforce: The Role of Humans in
a Machine Age.” The World Economic Forum, Jan 2019. Available online at: https://
www.reuters.tv/l/PeoC
Weber, Lisa (2018). “RPA and AI: Physician Practice and Hospital Use Cases,”
unpublished whitepaper.
World Health Organization (2018). “Public Spending on Health: A Closer Look
at Global Trends.” Available online at: https://apps.who.int/iris/bitstream/
handle/10665/276728/WHO-HIS-HGF-HF-WorkingPaper-18.3-eng.pdf?ua=1
Works Cited

Ui_RPA-in-Healthcare.pdf

More Related Content

Similar to Ui_RPA-in-Healthcare.pdf (20)

More from Shenthilkumar Subburam (20)

Recently uploaded (20)

Ui_RPA-in-Healthcare.pdf